Organization
DIVINE CARE HEALTH AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELSIE ADIBE (PSYCHIATRIC MENTAL HEALTH NURSE PRA)
(857) 574-4497
Entity
Organization
Contact information
Practice address
500 WESTGATE DR # 1016, BROCKTON, MA 02301-1855
(857) 574-4497
Mailing address
500 WESTGATE DR # 1016, BROCKTON, MA 02301-1855
(857) 574-4497
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
10/09/2021
Last updated
10/09/2021
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